Prewash, Mainwash and Greenwash – sustainability in decontamination context

This is really a continuation of the line of thinking from one of my first blogs/articles entitled “process versus result”. This time explored through sustainability, a big word that is now in fashion.

Sustainability is often simplified to “being green” and “eco”. These words, however, divert attention from the true essence of sustainable development. An often cited definition explains sustainable development as one “that meets the needs of the present without compromising the ability of future generations to meet their own needs.” (Brundtland Commission 1987). This concept is not a new thing but now it is getting into the day-to-day activities more than ever – also within the decontamination sciences.

For me, sustainability is first and foremost about the comprehension of what we do though the lens of its future consequences – social, economic and environmental.

Decontamination sciences carry the primary objective of reducing the risk of infection spread though instrumentation and equipment. This mission underpins research, technology development, use of equipment and management of resources and people and cannot be compromised. This, in my understanding, is the result of what decontamination sciences are aiming to achieve. However, how this goal is achieved is an entirely different issue and exactly the place where sustainability can be introduced. It is the result that matters and not the process.

When I think about the process, I would definitely like to see sustainable development being the principle behind it rather than one of its requirements. This way it will become an integral part of what and how we do things rather than a set of rules and guidelines we think how to get around. The alternative produces greenwash that, despite sounding similar to washer disinfector stages, has not much to do with the technology but rather the way products, services and actions are marketed and sold to us. The worst thing is that this approach works commercially and I also sometimes pat myself in the back for buying “green” solutions just to find out that I was the truth is not exactly as green as the marketing scheme.
We need to – without a doubt – follow the primary decontamination objective, but within the boundaries of our choice we can decide to use systems and solutions that use less energy, consume fewer resources and produce minimise waste.

One example is optimisation of washer disinfector cycles for more efficient use of process chemistry and energy. The key to this is the cycle time. Time is the trade-off for the amount and type of chemistry that is used in the process. Similarly, time is a trade-off for the amount of energy we put to heat up the load to high disinfection temperatures. This stems from the fact that most energy in typical washers is utilised for heating water rather than any other activity. Same principle can be applied to steam sterilisers.

From the technology point of view we need to think of the use of resources at the design stages and think of solutions that will focus on efficient resource use. Above all, we need to allow for much greater flexibility with the setup of cycle parameters so the small efficiencies can be found when different use of equipment is considered. Just like in the comparison between high volume reprocessing of commons simple instruments and low volume specialised loads. In both cases the same piece of equipment can be used for reprocessing but the processes need to be adapted to best suit particular loads.

The above is definitely not a universal piece of advice but some food for thought. When short cycle time is not essential, then perhaps it makes sense to make it a little longer and reduce disinfection temperature (according to the A0 concept) or use weaker, more environmentally friendly chemistry.

It is, yet again, all about understanding the context, understanding how contaminated loads flow through the overarching decontamination processes. When, on the other hand, short cycles are necessary, efficiencies must be found elsewhere – again through a thorough understanding of the context.

I think no matter where we sit in the decontamination environment we have a chance “do our bit” – at the end of the day we do it for ourselves.

Brundtland Commission (1987) Report of the World Commission on Environment and Development: Our Common Future. World Commission on Environment and Development, 1987. Published as Annex to General Assembly document A/42/427